Background: In Massachusetts, the 1983 decision of Rogers v. Commissioner of the Department of Mental Health, 390 Mass 489 (1983) determined a separate hearing is required to allow the administration of antipsychotic medications to individuals unable to consent to treatment. A Rogers Guardianship hearing allows for involuntary treatment to individuals who display anosognosia, or a lack of insight, and are civilly or forensically committed for treatment. The attorney, often appointed via the Committee for Public Counsel Services (CPCS) Mental
Health Litigation Unit, represents patients’ interests in the hearing. The judge uses the standard of ‘substituted judgement’ to grant the Rogers’ petition. Due to procedural reasons inherent in adversarial hearings, these proceedings are often delayed, which may lead to adverse events for the patient, including violence, self-injury, or milieu disruptions.
Methods: We will analyze 293 Rogers Guardianship petitions filed at a strict-security forensic hospital in Massachusetts, between 2015-2016 and calculate the delay between filing the Rogers petition and the court allowing it. We will analyze reasons for delay. Additionally, we will record the public defender’s experience of this process by an online survey using Qualtrics survey software, including perceptions on the Rogers Guardianship process and the delays to court hearings.
Results: We found that of the 293 total 8B petitions analyzed in our study, only two (~0.007%) were not upheld by a judge. We expect to find that our study will show certain reasons why the case was delayed and will reflect the backlog of cases in the courts. We expect our survey of attorneys will show the delays occur for administrative reasons and are often not related to the mental health aspects of the case. Furthermore, we expect subjects of the study will endorse their client’s mental health deteriorated as the legal process continued.
Conclusions: By better understanding delays in the court procedure to allow treatment plans for the seriously mentally ill, we will be more equipped to address these challenges and reduce the time to treatment for a vulnerable population.